Paediatricians advise parents to clean their little one’s ears regularly. Use a wet washcloth or a cotton swab to gently wipe the outer regions. Never remove the wax though, because it serves an important purpose ― to protect ears from damage.

But what happens when there’s too much gunk in your kid’s ears? Can it lead to hearing problems? And what about those dreaded ear infections that can plague peewees ― how can we avoid them or manage them properly?

Is it true that earwax keeps our ears healthy?

Ear wax is a mixture of shed skin cells, hair, wax and oil secretions. Though some may deem it “yucky” or dirty, it is actually protective. It lubricates the canal, traps dirt, protects the eardrums and deters insects from entering. The amount of wax we make is determined by genetics. Certain narrow or tortuous winding ear canals trap wax more easily. Excessive trapping of wax can cause ear pain, hearing reduction, dizziness, ear canal infection and tinnitus (ringing in the ears).

What’s the difference between dry earwax and wet earwax?

Genetics determines if you have wet or dry wax. If you are Asian or Native American, you are more likely to have dry yellow flaky wax. Africans and Europeans are more likely to have wet brown or dark wax.

Should parents be cleaning their kid’s ears?

Largely, wax is forced out naturally by our body, as cells migrate outwards from the eardrum to the outer ear. Cleaning of the ear canal occurs naturally without us feeling it, likely also assisted by jaw movements. I often tell my patients that my daughter is a teenager now, but I have never even looked into her ear, though I have all the equipment needed to remove ear wax. The ears need only to be cleaned if there is excessive trapped wax that your doctor deems need removing.

How does a doctor clean built-up earwax?

A general practitioner may use warm water irrigation to remove the wax. An ear, nose and throat practitioner would usually remove the wax under light microscopic visualisation with fine instruments like a jobson horn, tiny microhooks, or tiny suctions of various sizes.

Many parents may think that an ear blockage, discharge or smell is due to earwax. However, problems caused by earwax are much less frequent than other conditions such as middle ear or outer ear infections, blocked Eustachian tubes related to nasal allergies, sinus congestion and colds. It is also important to note that a blocked ear sensation and discharge can be a result of ear drum perforation or a tumour.

Any ear-cleaning home remedies to share?

If the ear wax has hardened, soften it up by putting in three to five drops of mineral oil or hydrogen peroxide for three to five days. There are various over-the-counter medications at the pharmacy you can buy for wax removal, too. However, all non-prescription ear drops should only be used if you are sure there’s no perforation of the ear drum.

For earwax removal, pull the ear gently back and up then use warm, but not hot water, in a bulb syringe to gently irrigate the ear canal, pointing the nozzle upwards and backwards to prevent trauma to the eardrum. However, since there is no visualisation of the ear canal and all ear canals have different anatomies, injury to the ear canal, ear drum or ear bones is always a risk. The risk is increased by sudden voluntary or involuntary movements, as the ear canal and drum are very sensitive and delicate.

By the way, ear candling has been highlighted by the USA FDA to be risky and not recommended for removal of ear wax. The cited risks are burns from hot wax, fire, eardrum perforation and infection.

Any tips to avoid swimmer’s ear?

Do not swim in dirty water, or when you have an ear infection. Be considerate and do not swim when you are sick, as you contaminate the pool and the infection spreads to others. If your child swims frequently, they may benefit from customised swim plugs if off-the-shelf ear plugs do not keep water out well enough.

During baths, bathing caps can help keep water out of the ears. After swimming, shake out the water from the ears. If junior gets frequent ear infections and you’re sure there’s no perforation of the eardrum, over-the-counter swim ear drops can be used to dry out the ear canals. Some also make their own mix of acetic acid or a combination of isopropyl alcohol and white vinegar to dry out their ears. If infection persists, do see a doctor to clean out the ear and give appropriate oral or topical antibiotics and ear pain medication.